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General NPI Number Information
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NPI Number | 1518804673
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Entity Type | Individual
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Provider Name | DONOVAN BRICE KELLY LPC-A
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Gender | Male
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Dates
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Enumeration Date | 04/29/2026
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Last Update Date | 04/29/2026
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Provider Practice Location Address
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Address Line | 12900 PRESTON RD STE 806
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City | DALLAS
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State | TX
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Zip | 75230-1379
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Country | US
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Telephone | 214-302-5572
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Fax |
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Provider Business Mailing Address
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Address Line | 2717 MISTY HARBOR DR
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City | LITTLE ELM
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State | TX
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Zip | 75068-5966
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Country | US
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Telephone | 682-808-0786
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 101929
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License Number State | TX
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